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OFFICE OF THE CHIEF MEDICAL EXAMINER
ANNUAL REPORT
2011 JANUARY 1 – DECEMBER 31
STATE OF OKLAHOMA
* Copies have been deposited with the Publications Clearinghouse of the Oklahoma Department of Libraries.
TABLE OF CONTENTS FORWARD .................................................................................................................................................. 1
BRIEF SUMMARY ...................................................................................................................................... 2
MANDATE .................................................................................................................................................. 3
FAMILY ASSISTANCE .............................................................................................................................. 4
OVERVIEW OF 2011 CASES .................................................................................................................. 5-6
AUTOPSY DATA ........................................................................................................................................ 7
EXTERNAL EXAMINATION DATA ........................................................................................................ 8
HOMICIDE DEATHS .................................................................................................................................. 9
SUICIDE DEATHS .................................................................................................................................... 10
ACCIDENTAL DEATHS .......................................................................................................................... 11
TRAFFIC DEATHS ................................................................................................................................... 12
NATURAL DEATHS ............................................................................................................................ 13-14
UNDETERMINED DEATHS .................................................................................................................... 15
SUDDEN INFANT DEATH SYNDROME .......................................................................................... 16-20
TEN YEAR COMPARISON ................................................................................................................. 21-30
TOP DRUGS DETECTED ......................................................................................................................... 31
2011 ANNUAL REPORT
OFFICE OF THE CHIEF MEDICAL EXAMINER 901 N. STONEWALL
OKLAHOMA CITY, OKLAHOMA 73117
Page 1
F O R E W A R D
The Office of the Chief Medical Examiner of the State of Oklahoma has the sole responsibility for
investigating sudden, violent, unexpected and suspicious deaths. Information gained from these
medicolegal investigations is frequently required in the form of evidence and expert testimony in both
criminal and civil legal proceedings.
When a death occurs on the job or appears to be work-related, the results of the medicolegal investigation
are of direct benefit to the family in order that insurance claims may be appropriately settled. These
examinations also help identify potentially unsafe consumer products. The public health function of the
medical examiners office is further apparent in the investigation of cases in which poisons or infectious
agents are implicated. The identification of such dangerous elements allows the prompt implementation
of treatment and preventive measures through coordination with Oklahoma's Public Health Agencies and
OSHA.
The staff of the Office of the Chief Medical Examiner recognizes and is sensitive to the personal tragedy
surrounding an untimely or violent death. The staff members interrelate daily with families of victims
and serve on many community related activities such as the Child Abuse Prevention Taskforce, the
Domestic Violence Fatality Review Board and the Child Death Review Board. Medicolegal education is
offered to medical, dental, pharmacy, nursing students, physicians, police officers and lay groups having
interest in topics to which the medical examiner relates. Cooperation with other state and federal
agencies such as the Oklahoma State Department of Health and the Centers for Disease Control in Atlanta
allows information generated by the medical examiner to be utilized in epidemiological surveillance and
development of public health programs.
Most importantly, the Office of the Chief Medical Examiner represents a resource of impartial
professionals and support staff providing continuous objective medicolegal investigations to the people of
Oklahoma.
Page 2
M E D I C A L E X A M I N E R C A S E S I N 2011
B R I E F S U M M A R Y
In 2011, there were 36,309 deaths reported in the State of Oklahoma. Of these, 21,208 were reported to
the medical examiner by medical and law enforcement personnel. Based on the analysis of the scene and
circumstances of death and the decedent’s medical history, the medical examiner assumed jurisdiction in
17,256 of these reported deaths. Of these, 14,685 were investigated because they were going to be
cremated, shipped out of state or ultimately made unavailable for pathological study. Throughout the
presentation and discussion of data that follows, except where stated, these cases are excluded.
Complete investigations and examinations were performed in 5332 cases. Of these, 1323 were selected
for autopsy. Autopsies by forensic pathologists were not performed in deaths where scene investigation,
circumstances, medical history, and external examination of the body provided sufficient information for
death certification.
Specific presentation of relevant tables regarding 2011 cases follows this brief summary.
Page 3
OFFICE OF THE CHIEF MEDICAL EXAMINER
STATE OF OKLAHOMA
The Oklahoma Medical Examiner's system came into being in 1961. It was without funding until 1967.
The Office of the Chief Medical Examiner of the State of Oklahoma operates under the control of the
Board of Medicolegal Investigations through the provisions of the Oklahoma Statutes. The office is
directed by the Chief Medical Examiner who is a licensed physician, trained and certified in forensic
pathology, the branch of medicine concerned with the investigation of sudden, unexpected, violent or
suspicious death. The office provides toxicological and pathological services to aid in the investigation of
death defined by law as being subject to public inquiry.
In the State of Oklahoma, the medical examiner is the medical officer charged with the medical aspects of
death investigation. The medical examiner is an officer of the state charged with certain statutory powers
and duties.
The law requires that all human deaths of the types listed below must be reported to the medical examiner
and investigated by him.
1. Violent deaths, whether apparently homicidal, suicidal or accidental including but not limited to
deaths due to thermal, chemical, electrical or radiational injury and deaths due to criminal abortions,
whether self-induced or not.
2. Deaths under suspicious, unusual or unnatural means.
3. Deaths related to disease which might constitute a threat to public health.
4. Deaths unattended by a licensed medical or osteopathic physician for fatal or potentially fatal illness.
5. Deaths of persons after unexplained coma.
6. Deaths that are medically unexpected and that occur during a therapeutic procedure.
7. Deaths of any inmate occurring in any place of penal incarceration.
8. Deaths of persons whose bodies are to be cremated, buried at sea, transported out of state or
otherwise made ultimately unavailable for pathological study.
Page 4
FAMILY ASSISTANCE The Office of the Chief Medical Examiner is the sole entity responsible for establishing the cause and manner of death for the State of Oklahoma in types of deaths specifically defined by Oklahoma Statute. Deaths caused by homicide; or those of a suspicious nature, obviously generate a substantial amount of interest from family members, friends, the general public and the media. The State of Oklahoma averages several hundred of these deaths per year. Relatives and friends of these decedents, unfortunately can get lost in the whirlwind chaos of the aftermath of the victim’s death. When informed and confronted with their unexpected loss they can be left alone trying to determine what actually occurred and what to do next after a build up of disbelief regarding the death of their loved one or friend. As a result of several major catastrophes in Oklahoma and the every day experiences of personal tragedies by numerous families, this Agency became painfully aware of the countless questions individuals seek. The search for prompt answers to their questions seems to never end. Since 1999, with the assistance of a federal grant from the Victim’s of Crime Act (VOCA) through the U.S. Department of Justice and monitored by the Oklahoma District Attorney’s Council, the Office of the Chief Medical Examiner has been able to greatly expand its services to assist families and friends of those who suffer violent deaths with the creation of the Family Assistance Coordinators. The Central and Eastern Office each have a coordinator available. The coordinators ensure that medical and investigative information is provided to families and friends without delay. Efforts are made to get responses to their countless inquiries about medical questions, circumstances as to the cause of death and what to expect from a variety of other agencies they are introduced to because of death. The Family Assistance Coordinators keep close contact with the families and friends as the case proceeds through the many facets of the death investigation. In addition, the Family Assistance Coordinators keep families informed as to the many monetary benefits available to them through the VOCA Grant. These benefits assist families with the burdensome and frequently unexpected out-of-pocket expenses for funeral costs, economic losses, medical costs and professional grief counseling. Coordinators also assist in informing families and friends of what they may encounter from their unexpected introduction into the criminal justice system. By communicating closely with other victim or community service’s, relatives and friends are better prepared for the sometimes cruel and unbelievable circumstances surrounding their loved one’s death. As a result of this Agency’s dedication in dealing with the various family issues and questions which arise from traumatic deaths, a development of trust and dependability has been created between the Office of the Chief Medical Examiner and the families and friends it serves.
59% of all deaths in Oklahoma were reported to the Medical Examiner.
*2762 of the cases cremated/transported out of state were also medical exmainer
cases for other reasons and were examined and/or autopsied.
EXTERNAL EXAMINATION
401017%
JURISDICTION WAIVED395216%
CREMATIONS1232451%
AUTOPSIES13236%
TRANSPORT OUT OF STATE236110%
201136309 TOTAL DEATHS IN OKLAHOMA
21208 REPORTED TO THE MEDICAL EXAMINER
Page 5
TRAFFIC75514%
HOMICIDE2665%
SUICIDE69613%
UNDETERMINED
2775%
NATURAL185735%
ACCIDENTAL148128%
MEDICAL EXAMINER CASESEXAMINED AND/OR AUTOPSIED
TOTAL 5332
Page 6
TRAFFIC333%
HOMICIDE25619%
SUICIDE625%
UNDETERMINED17713%
NATURAL35727%
ACCIDENTAL43833%
MEDICAL EXAMINER CASES AUTOPSIED TOTAL 1323
Page 7
TRAFFIC 722 16%
HOMICIDE100%
SUICIDE 634 14%
UNDETERMINED1013%
NATURAL 1500 34%
ACCIDENTAL104326%
MEDICAL EXAMINER CASES EXAMINED TOTAL4010
Page 8
0
32
8
173
34
5
14
UNKNOWN
STABBING
OTHER VIOLENCE
FIREARM
BLUNT IMPACT
ASPHYXIA
ABUSED CHILD
0 20 40 60 80 100 120 140 160 180 200
HOMICIDE DEATHS ‐ 266
Page 9
11
16
142
441
70
10
6
STAB/INCISED
OTHER
HANGING
FIREARM
DRUGS/POISONS
CARBON MONOXIDE
ASPHYXIA
0 50 100 150 200 250 300 350 400 450 500
SUICIDE DEATHS ‐ 696
Page 10
1
3
3
3
16
13
12
11
30
5
10
77
13
477
10
7
656
70
5
2
18
33
0
1
5
UNKNOWN
TRAIN
THERAPEUTIC
SHARP FORCE
OTHER
LIGHTNING/WEATHER
IND. MACHINERY
HYPOTHERMIA
HYPERTHERMIA
HORSE/BULL
FIREARM
FIRE/BURN/SMOKE
FARM MACHINERY
FALLS
FALLING OBJECT
ELECTROCUTION
DRUGS/POISON
DROWNING
CARBON MONOXIDE
BOAT
ATV
ASPHYXIA
ANIMAL/INSECT
ANAPHYLAXIS
AIRCRAFT
0 100 200 300 400 500 600 700
ACCIDENTAL DEATHS ‐1481
Page 11
2
29
56
15
101
195
24
4
329
0 50 100 150 200 250 300 350
VEHICLE/TRAIN
UNKNOWN
SUV
OTHER
MOTORCYCLE
LIGHT TRUCK
HEAVY TRUCK
BICYCLE
AUTO
TRAFFIC DEATHS ‐ 755
Page 12
6
0
114
36
10
15
54
22
28
13
15
20
10
58
76
81
1299
0 200 400 600 800 1000 1200 1400
UNKNOWN
THERAPEUTIC
RESPIRATORY
PEDIATRIC
OTHER
MUSCULOSKELETAL
MALIGNANCY
INFECTIOUS
HEPATIC
HEMATOLOGIC/IMMUNOLOGIC
GI
GERIATRIC
GENITOURINARY
ENDOCRINE
CENTRAL NERVOUS SYSTEM
CHRONIC ETOH
CARDIOVASCULAR
Deaths that are classified as natural are those that occur in conformity with the ordinary course of nature. They generally come under the jurisdiction of the medical examiner because they are sudden and unexpected, often in individuals who are not being followed for any known potentially lethal disease. Some come to the attention of the medical examiner because circumstances surrounding the death arouse suspicion. In 2011, 1857deaths were certified by the medical examiner as attributable to natural causes. Of these, 1299(70%) were attributed to cardiovascular disease.
NATURAL DEATHS ‐ 1857
Page 13
1
3
3
174
44
0
18
147
900
7
2
0 100 200 300 400 500 600 700 800 900 1000
VALVULAR HEART DISEASE
OTHER
INFLAMMATORY HEART DISEASE
HYPERTENSIVE HEART DISEASE
CONGESTIVE HEART FAILURE
CONGENITAL HEART DISEASE
CARDIOMYOPATHY/HYPERTROPHIC
CARDIAC DYSRHYTHMIA/ARRHYTHMIA
ARTERIOSCLEROTIC HEART DISEASE
AORTIC DISSECTION
AORTIC ANEURYSM
CARDIOVASCULAR BY TYPE ‐ 1299
Page 14
0
4
10
1
63
103
3
4
0
6
69
3
0
11
0
0
0 20 40 60 80 100 120
TRAIN
TRAFFIC
STILLBORN
STABBING/CUTTING
SIDS/OVERLAY/CO‐SLEEPING
OTHER
FIREARM
FIRE/BURN/SMOKE
FALL
EXPOSURE
DRUGS/POISON
DROWNING
CARBON MONOXIDE
BLUNT INJURY
ASPHYXIA
AIRCRAFT
UNDETERMINED DEATHS ‐ 277
Page 15
23
15
1921
15
6365
53
70
60
0
10
20
30
40
50
60
70
80
2007 2008 2009 2010 2011
SIDS UNKNOWN
INFANT DEATHS ‐ FIVE YEAR COMPARISON
Page 16
1
2 2
1
2
1
2
0
2 2
0 0
2
8
4
2
6
11
3
4
5
7
2
6
0
2
4
6
8
10
12
JAN FEB MAR APR MAY JUNE JULY AUG SEPT OCT NOV DEC
SIDS UNKNOWN
INFANT DEATHS CLASSIFIED BY MONTH
Page 17
22
38
0
5
10
15
20
25
30
35
40
FEMALE MALE
SIDS UNKNOWN
INFANTS CLASSIFIED BY GENDER
Page 18
8
0
2 2 21
43
0 0
4
9
4
0
5
10
15
20
25
30
35
40
45
50
WHITE UNKNOWN OTHER HISPANIC BLACK AM INDIAN
SIDS UNKNOWN
INFANTS CLASSIFIED BY RACE
Page 19
4
2
3
2
1 1 1 1
0 0 0
18
8
12
9
5
2
3
2
0
1
00
2
4
6
8
10
12
14
16
18
20
< 2 M 2 M 3 M 4 M 5 M 6 M 7 M 8 M 9 M 10 M 11 M
SIDS UNKNOWN
CLASSIFIED BY AGE ‐ UNDER 12 MONTHS
Page 20
JURSIDICTION ASSUMEDTEN YEAR COMPARISON
10189
10989
11628 11775
1299013307
13898
1488715332
16293
17256
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
Page 21
CASES AUTOPSIEDTEN YEAR COMPARISON
1530
1674
1499
1598
18511884
1599
1493
1870
1645
1323
0
200
400
600
800
1000
1200
1400
1600
1800
2000
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
Page 22
ACCIDENT CASES INCLUDING TRAFFICTEN YEAR COMPAIRSON
1496
15641625
1786
1883 1883
2012
21002160
22102236
0
500
1000
1500
2000
2500
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
Page 23
HOMICIDE CASESTEN YEAR COMPARISON
268
230
270
252
247
250
268
253
265
231
266
210
220
230
240
250
260
270
280
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
Page 24
NATURAL CASESTEN YEAR COMPARISON
1497
17011650
1600
17431788
1692
19081966
18881857
0
500
1000
1500
2000
2500
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
Page 25
SUICIDE CASESTEN YEAR COMPARISON
523 528
480
516534
544 539
593582
648
696
0
100
200
300
400
500
600
700
800
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
Page 26
UNDETERMINED CASESTEN YEAR COMPARISON
113
128
173
159
213 212
203
228
242
279 277
0
50
100
150
200
250
300
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
Page 27
CREMATION CASESTEN YEAR COMPARISON
5220
5664
6367 6493
7309
8045
8604
9418
10167
11294
12324
0
2000
4000
6000
8000
10000
12000
14000
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
Page 28
OUT OF STATETEN YEAR COMPARISON
1922
21252069
1955
2360 23712406
2468
2359 2384 2361
0
500
1000
1500
2000
2500
3000
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
Page 29
JURISDICTIOIN WAIVEDTEN YEAR COMPARISON
1898
2106 2127 2132
2414
2758
32683215 3192
3759
3952
0
500
1000
1500
2000
2500
3000
3500
4000
4500
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
Page 30
TOP DRUGS DETECTED
216
84
158
34
73
235
135
6559
283
14
97
200
6
174
13
191
52
33
57
74
33
20
0
50
100
150
200
250
300
Page 31
